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House: Give hospitals new shot at Medicaid managed care pact

Associated Press

Sunday, February 11, 2018

JACKSON, Miss. (AP)

Mississippi House and Senate negotiators will have to sort out whether they want to give in-state hospitals another shot at a big Medicaid contract, after House members included that proposal in their version of a bill to renew the state-federal health insurance program.

The move came as the House voted 107-4 Thursday to pass House Bill 898, which would renew legislative authorization for the health insurance program that covers 750,000 Mississippians, including nursing homes patients, disabled adults, pregnant women and young children.

The debate is one of the 2018 Legislature's most important, as health care providers jockey for a slice of the nearly $6 billion that Medicaid spends annually, while lawmakers try to hold down the state's share of the costs, projected at $945 million this year.

Lawmakers must vote on reauthorizing the program this year or parts would expire.

Republicans defeated a move by Democrats to expand Mississippi's Medicaid program to cover more people as foreseen under the Obama health care overhaul. The vote was along party lines.

The move by Rep. Jason White, a Republican from West, would give a 60-hospital organization known as Mississippi True another chance to win a slice of Medicaid's managed care business. The Clarion Ledger reports that contract channels spending for 70 percent of the 750,000 Mississippians covered by Medicaid, paying companies a per-patient, per-month rate to manage the health care. Managed care is Mississippi's main strategy to control Medicaid costs.

Medicaid rejected Mississippi True's proposal last summer, instead retaining Centene Corp., UnitedHealthcare and adding Molina Healthcare to the new three-year managed care contract beginning in October.
Mississippi True is suing Medicaid, saying it was unfairly penalized as the contract was awarded. Hospitals wanted a share of the business in part because they and other health care providers complain that it's hard to get paid by managed care insurers.

The House bill would require that a new contract be awarded by July 2019 and that Medicaid not penalize Mississippi True or another provider-sponsored health plan for a lack of experience.

"What we're trying to do is find a way to dissolve what was going on and make the process a little more transparent," said Rep. John Hines, a Greenville Democrat.

An earlier House proposal would have automatically given Mississippi True 10 percent of the patients covered by managed care, but some members objected to awarding a contract without taking bids.
Medicaid officials said they weren't sure yet how the mandate would affect the agency. However, Gov. Phil Bryant, who controls the agency, is supporting the move.

"Gov. Bryant appreciates the House leadership working toward a solution that is in the best interest of Medicaid beneficiaries," Chandler said. "He intends to let the legislative process play out and will work with leadership in both chambers to reach an agreement."

Rep. Jarvis Dortch, a Raymond Democrat, questioned whether interfering in contracting was wise, especially considering the ongoing lawsuit. He also asked whether California-based Molina, the new provider selected this summer, would sue the state.

The House bill also includes a provision ensuring Medicaid coverage for treating opioids. Rep. Cheikh Taylor, a Starkville Democrat, amended it to add treatment for "other highly addictive substances."